Can a spreader graft be used to raise the bridge, or only widen it in rhinoplasty?

To answer your question, yes, a spreader graft can be used to raise the upper lateral cartilage, and that is its primary function. If the upper lateral cartilage collapses after primary rhinoplasty, the spreader graft will raise it back up to the proper position. It doesn't necessarily have to widen the nose. It is important to see a rhinoplasty specialist in person so he/she can examine you and determine the best course of action.

Thank you for an excellent question.  Spreader grafts are pieces of cartilage placed between the upper lateral cartilage and the dorsal cartilage.  After a rhinoplasty, the angle between these two structures can become too acute, which creates a narrow angle and reduced airflow.  By placing a spreader graft, the angle is slightly opened, which creates more room for air passage.  There are other uses for spreader grafts as well.  They can be used as struts to straighten a crooked nose, or lengthen an overly short nose.  While they can add a small amount of dorsal height,  there are other types of grafts and implants that work better for this need.I would suggest consulting with a plastic surgeon with significant rhinoplasty experience.  Spreader grafts and other types of grafts in the nose require finesse and experience to get the best results.Best of luck with your nose.Jeff Rockmore

Dear Little Miss,In a word, yes, spreader grafts can be used to augment the dorsum of the nose.  They are not generally considered the best way to do that, depending on where the elevation is needed.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for options.  Good luck!

Graft in general can be used in many different ways.  A spreader graft is used to increase the middle vault angle to aid in breathing.  It can also help straighten the middle vault.

A spreader graft placement can be used on one or both sides of the nose to widen it and open up the nasal valve. They are performed when the upper lateral cartilages are concave and need widening. A dorsal onlay cartilage graft is used to build up the bridge height. For more information and many examples, please see the link and video below

Spreader grafts are used to increase the distance between the upper lateral cartilages and the nasal septum.  In theory, this increases the cross-sectional area of the nasal airway (although likely very little).  It may have a secondary mild widening effect of the cartilagenous nasal dorsum.  In a nose that has already undergone reduction, dorsal onlay grafting (placing cartilage on top of the the upper lateral cartilages) is often used for increasing projection.  This likely has a more predictable result than using spreader grafts to acheive the same result.  As always, it  is important to consult with a board-ceritifed Plastic Surgeon who has a particular interest in rhinoplasty.

Spreader grafts are veritable work horses when it comes to contemporary rhinoplasty! They are tiny pieces of cartilage that are hand carved by your rhinoplasty surgeon from various sources, including septal cartilage, ear cartilage, rib cartilage, or cadaveric rib cartilage. Spreader grafts are most commonly used to open the nasal airway at its tightest point, the internal nasal valve, to improve nasal breathing. When done correctly, there is virtually no appreciable widening of the nose (unless of course you have a depression on the sidewall of your nose that your surgeon wants to repair). The other less commonly touted feature of spreader grafts, is that in situations of an overly resected low nasal bridge, spreader grafts can also be used to raise the low dorsum, giving a more natural, less pinched or sunken appearance. So spreader grafts are versatile - they contribute to a better airway, and a better looking nose!

Rather than talking about different techniques in the abstract when there are multiple problems that you describe I've always felt that we can be more helpful if the patient submits representative pictures.